Friday, February 26, 2016

Abortion Clinics Closing

By Randall K. O’Bannon, Ph.D., NRL Director of Education & ResearchThat
abortion clinics are closing is not really news. They have been closing
for years, for reasons we have explained at great length at NRL News and NRL News Today.
But with states passing clinic regulation laws and the Supreme Court scheduled to hear challenges to Texas’ HB2 next month (Whole Woman’s Health v. Hellerstedt), it is not hard to guess the reason for the media’s sudden interest in the closings (see here).
However, it is vitally important to take every reason they offer as
an explanation–primarily the claim that the decline in numbers is the
result of the passage of pro-life laws–with a shaker of salt.
For example, yesterday Bloomberg Businessweek published results of its own investigation under the headline “Abortion Clinics Are Closing at a Record Pace.” Bloomberg
claimed that since 2011, at least 162 “providers” had shut their doors
or stopped offering abortions. During that same time, just 21 new
clinics opened.

Whether this constitutes a “record” or whether Bloomberg
used the same criteria for identifying and counting clinics that long
time abortion industry researcher the Guttmacher Institute uses, is hard
to tell. That said, a loss of 141 clinics in five years would be
significant.
The highest number of abortion “providers” ever identified by the
Guttmacher Institute, which has tracked abortion statistics since the
earliest days of Roe and was once a special research affiliate of
abortion giant Planned Parenthood, was 2,918 in 1982. Those numbers have
declined steadily ever since.

Guttmacher recorded just 1,720 in 2011 in its most recently published clinic figures.
Note that the biggest drop it recorded was for the period 1992 to 1996,
when the number of “providers” declined from 2,380 to 2,042.

Continuing a trend that Guttmacher reported between its 2008 and 2011
abortion reports, a significant portion of the drop Bloomberg found was
among clinics performing 400 or more abortions a year. Guttmacher
identified 553 that met this criteria in 2011; Bloomberg says its study
showed an average of 31 clinics per year closing or stopping performance
of abortions since that time.
There are no new national abortion numbers from Guttmacher since that
time. However clinic closings and a decline in the number of abortions
have generally gone hand in hand. And available state data for 2012 and
forward seems to indicate further declines.Bloomberg echoes the line of the abortion industry, saying
that this vanishing number of clinics is “propelled by Republican state
lawmakers’ push to legislate the industry out of existence.” While one
hopes that these laws have been effective in protecting both mothers and
their unborn babies from the horrors of abortion, Bloomberg’s own data
points to a broader range of reasons and, to the keen observer, hints at
some dangerous trends in the data.
Bloomberg does not give precise numbers, but a chart accompanying its
report appears to show between 40-50 clinics closing because of
“legislation.” This is not explained or identified for each clinic, but Bloomberg
says that “State rules that make it too expensive or logistically
impossible to remain in business drove most of Texas’s closings – at
least 30.”
But Bloomberg finds other reasons behind many of the other
closures which are ignored by the sky-is-falling crowd. It doesn’t say
how many or mention them by name, but it does show what appears to be at
least seven closures for what it terms to be “unfit providers” in
Michigan, Ohio, Oklahoma, and places along the Maryland, Delaware, New
Jersey, and Pennsylvania corridor. (It is hard to tell with precision on
the accompanying map.)
“Business decisions” were responsible for nearly forty of the closures, including 14 in Iowa operated by Planned Parenthood. Bloomberg says Planned Parenthood “attributes the drop to changing demographics and industry consolidation.”
In English, for groups like Planned Parenthood, what this often meant
was the closing of smaller satellite offices and the building of giant
new megaclinics. So it‘s not the least bit surprising that there are
several places on the map showing a new clinic being built amidst
multiple closures.
What are some other reasons? We also know, from observing recent
Planned Parenthood history that the national office has had to
disaffiliate some members and close clinics for financial or other
mismanagement (ex., Planned Parenthood Golden Gate in 2010, Planned
Parenthood of South Palm Beach and Broward Counties, 2008). Some of
these clinics later reappear under a new affiliate, so the net effect is
hard to calculate.
Between 15-20 clinics closed, says Bloomberg, because there
was “no doctor available.” This is the reason that states like
California are pushing to have physician assistants, nurse
practitioners, and nurse midwives authorized to perform abortions and
why organizations like Planned Parenthood’s large Heartland affiliate
have pioneered web-cam abortions that are designed to minimize the need
for direct medical supervision.

The biggest category of clinic closures are due to what Bloomberg
terms “unknown/other” reasons not specified. This described perhaps
50-60 of the closures, many in states like California. This is
particularly telling because, as Bloomberg notes, California “lost a
dozen providers, showing availability has decreased even in states led
by abortion-rights friendly Democrats.”
Buried in the story is an admission that “declining demand” for
abortion was also one of the factors behind the clinic closures. That’s
bad news for abortion clinics but good news for everyone who does not
have an interest in keeping the number of abortions as high as possible.
Many clinics were closing because there simply was not sufficient
business! Abortions have fallen from 1.6 million in 1990 to just over a
million in the latest Guttmacher report for 2011. This latest data lends
support to the expectation of additional declines after that.
This loss of business is not something for which the
abortion industry is going sit still. As we have noted, they have
challenged clinic safety regulations in the courts. They are trying to
recruit and train new abortionists from the ranks of nurses, midwives,
and physician assistants.
They will promote web-cam abortions that require fewer trained
medical personnel, less office space, and less specialized medical
equipment. They will build giant, new shiny regional mega-clinics that
can handle large caseloads.

Hints of this industry transition are seen in the numbers. Bloomberg
says that “Of all the facilities in the nation that closed or stopped
performing terminations, about a third were operated by Planned
Parenthood; of the ones that opened, three-quarters were.”
If you didn’t understand Planned Parenthood’s corporate model, you
would be surprised that even as the number of abortions has dropped
enormously, its totals have held steady. Clearly, PPFA’s new megaclinics
are picking up the slack from the closing of its old storefront
abortion clinics.
Planned Parenthood bears close watching. The larger picture, however,
shows that the market itself is collapsing, that there simply isn’t
enough demand to keep all these abortion clinics in business.
And that is good news for future generations.